Am I a Safe Driver? Evaluating Older Driver Safety

Mobility is essential for ensuring independence and continued engagement of older adults in their communities. Deciding to give up the keys is a major life-changing event. The services discussed in this blog support older adults and their families who are struggling with the decision to give up the keys. Unfortunately, many older adults wait until they stop driving before trying public transportation, even though they could benefit from these services even as they continue to drive. Building connections between programs that support older driver safety and public transportation providers can help to ensure smoother transitions to non-driving and encourage older adults to begin using public transit or community transportation options sooner.

Credit: Fitness to Drive, Colorado Springs, Colorado

Driving is more than just a way to get around. It represents freedom, independence, and connection to the people and places that make life meaningful. Whether it’s a weekly grocery trip, meeting a friend for coffee, going to a medical appointment or picking up a grandchild from school, driving is often central to our daily lives.

But sometimes, health changes—like a stroke, injury, or memory concerns—can make us wonder: Am I still safe behind the wheel? If you know someone who is asking this question, then you have the opportunity to help them explore their options and ensure they have the right support to stay safe and confident.

What Does “Fitness to Drive” Mean?

Fitness to drive isn’t just about passing a vision test or renewing a license. It’s about making sure someone has the physical, mental, and sensory abilities to handle the complex demands of driving. This includes things like reaction time, attention, judgment, strength, and coordination—all of which can be affected by aging or medical conditions like arthritis, brain injury, Parkinson’s disease, or dementia.

According to the Insurance Institute for Highway Safety, 87 percent of adults age 70 and older are licensed drivers. And drivers ages 65 and older now represent more than 22 percent of all licensed drivers. With so many older adults on the road, it’s important to recognize that safety and independence can go hand in hand.

This is where occupational therapists (OTs) come in. OTs are healthcare professionals who help people do the everyday activities that matter to them, including driving.

Comprehensive Assessments: How OT Can Help

When it comes to driving, OTs assess how an individual’s health status and physical, visual, and thinking abilities impact their driving skills, helping them understand their strengths and identify areas of concern. In the context of fitness to drive, the OT conducts a comprehensive assessment. This can involve evaluating an individual’s physical abilities (such as strength, range of motion, and coordination), cognitive skills (like attention, memory, and judgment), and sensory processing (such as visual and auditory processing). After the in-clinic testing, the OT driving specialist will complete a behind-the-wheel assessment in a vehicle that has a passenger brake. The last step is a consultation to discuss the results from the assessment and make a plan for the future.

OTs support the whole person, including families, to navigate tough decisions, help drivers understand their abilities and limits, and empower them to make choices that prioritize both safety and independence. Sometimes this means continuing to drive with the right supports or adaptations in place. Sometimes it means making the hard decision to hang up the keys. Either way, OTs walk alongside individuals and families with compassion and expertise.

Community Support: Working Together for Safer Roads

Occupational therapy for driving is often a private pay service, as Medicare does not recognize driving as “medically necessary.” In Colorado Springs, Colorado, a partnership between the local occupational therapy program and the Pikes Peak Area Agency on Aging (PPAAA) covers the driving evaluation cost for community members over the age of 60 with Older Americans Act funds. This fantastic partnership benefits the community as a whole, enables access to important driver safety services and allows people to maintain driving independence for better mental and physical health. The Area Agency on Aging provides information on other services that may be needed, including access to transportation services as needs change over time. When individuals must make the difficult decision to give up their keys, the PPAAA provides assistance with identifying transportation alternatives. This partnership reflects a strong commitment to helping people stay safe, connected, and independent for as long as possible.

Changing driving habits does not mean someone has to lose their independence. By offering the right information and support, older adults and their families are empowered to make decisions that prioritize both their freedom and well-being.

Terri Cassidy, OTD, OTR/L, CDRS is an occupational therapist and the founder of Fitness to Drive (formerly Health Promotion Partners), which provides occupational therapy services for driver safety. Her current outreach includes programming and resources on the topics of older driver safety and driving with neurodivergence. Learn more about services at https://www.fitnesstodrive.org/ or contact her at Terri@fitnesstodrive.org